Cervical instability presenting as thoracic pain: case report and literature review.

STUDY

DESIGN

Case report.

OBJECTIVE

To report a case of cervical instability from an os odontoideum that presented as posterior thoracic pain and to present a review of the literature.

BACKGROUND

Thoracic posterior paraspinal spasms and pain are common chief complaints in individuals with spinal abnormalities.

METHODS

A 19-year-old man presented with posterior thoracic pain for nearly 1 year following a college sports-related injury (lacrosse). Computed tomography and magnetic resonance imaging did not reveal any significant thoracic or lumbar spinal cord or nerve root pathology, but did reveal an incidental finding of an os odontoideum.

RESULTS

Surgical stabilization of the atlantoaxial instability resulting from the os odontoideum resulted in complete resolution of the patient's thoracic pain.

CONCLUSIONS

Thoracic back pain without a clear thoracic spine etiology warrants further workup to rule out the possibility of spinal instability.